Rapid rituximab infusion: local center experience

ABSTRACT

Rituximab, a chimeric monoclonal antibody [MoAb] targeting CD20 has been widely used in the management of B-cell lympho-proliferative disorders.[1-3] The usual recommended schedule of regular administration over 3 to 4 hours requires considerable healthcare resources and oftentimes inconvenient for patients. Literature shows the availability of published reports proving the safety and feasibility of rapid infusion of rituximab. This study explored the safety and tolerability of rituximab infusion over a shorter total infusion time. A total of 24 patients diagnosed with CD20+ Non-Hodgkin's lymphoma and planned to receive rituximab at a dose of 375mg/m2 in combination with standard chemotherapy regimens were included in the study from January 2009 to December 2009. The administration of first rituximab dose was unaltered and given as per standard practice of 3-4 hours infusion. The second and subsequent doses were delivered over a total infusion time of only 90 minutes [20% of dose in the first 30 minutes, remaining 80% over the next 60 minutes]. These patients, aged between 15 and 79 years, received a total of 152 rituximab infusions with an average of 6.33 [ +/- 2.37] infusions per patient. Grade 1 infusion related toxicity was reported in 5 infusions [3.2%], and there were no acute reactions or G3/4 toxicity in any infusion episode. A rapid infusion of rituximab is well tolerated, feasible and safe when administered as second and subsequent infusions in the course of therapy for those who tolerate the first dose without significant infusion related toxicity. This shortened infusion method results in a substantial reduction in resource utilization. Our institution has now adopted this as a routine practice